诊断学理论与实践

诊断学理论与实践 >

2024 , Vol. 23 >Issue 05: 517 - 523

DOI: https://doi.org/10.16150/j.1671-2870.2024.05.008

论著

18F-氟脱氧葡萄糖正电子发射断层扫描/磁共振成像（18F-FDG PET/MRI）在诊断胰腺癌术后复发中的价值

  • 冯国伟 ,
  • 黄新韵 ,
  • 孟宏平 ,
  • 江旭峰 ,
  • 陈克敏 ,
  • 林晓珠
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  • 上海交通大学医学院附属瑞金医院 a.核医学科；b.放射科，上海 200025
林晓珠 E-mail: lxz11357@rjh.com.cn

收稿日期: 2024-06-08

  录用日期: 2024-10-08

  网络出版日期: 2025-02-25

基金资助

上海市科委项目(20Y11912300)

收起

Value of 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) in diagnosis of postoperative recurrence of pancreatic cancer

  • FENG Guowei ,
  • HUANG Xinyun ,
  • MENG Hongping ,
  • JIANG Xufeng ,
  • CHEN Kemin ,
  • LIN Xiaozhu
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  • Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; b. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2024-06-08

  Accepted date: 2024-10-08

  Online published: 2025-02-25

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摘要

目的：评估18F-氟脱氧葡萄糖正电子发射断层扫描/磁共振成像（18F-fluorodeoxyglucose positron emission tomography/magnetic resonanceimaging，18F-FDG PET/MRI）在胰腺癌术后复发诊断中的价值。方法：连续纳入2018年4月至2023年12月期间86例胰腺癌切除术后的患者，在2024年8月至9月行18F-FDG PET/MRI检查。回顾性分析18F-FDG PET/MRI检测胰腺癌术后复发的效能，比较PET/MRI和血清糖类抗原19-9（CA19-9）水平在诊断复发的效能。结果：经随访证实，86例患者中有67.4%（58/86）发生了肿瘤复发。复发组的原发肿瘤直径大于未复发组[（3.4±1.3）cm比（2.7±1.2）cm]。复发的患者中，87.9%（51/58）为系统性复发，最常见的是肝脏转移和腹膜转移。PET/MRI检查结果改变了30.2%（26/86）患者的治疗方案。86例中，有79例患者同时检查了PET/MRI和血清CA19-9，在诊断胰腺癌术后复发中，PET/MRI显示出比血清CA19-9更高的诊断效能（AUC：0.847对0.719）。PET/MRI检出9/12例血清CA19-9正常的胰腺癌复发，排除了5/8例血清CA19-9升高的未复发患者。结论：PET/MRI在胰腺癌术后复发诊断中具有较大的临床价值，其不仅能诊断是否复发，还能提供肿瘤复发的具体部位，对于血清CA19-9正常的患者，PET/MRI检查更有意义，为下一步治疗方案的制定提供全面的信息。

关键词： 胰腺导管腺癌; 复发; 18F-FDG PET/MRI

本文引用格式

冯国伟 , 黄新韵 , 孟宏平 , 江旭峰 , 陈克敏 , 林晓珠 . 18F-氟脱氧葡萄糖正电子发射断层扫描/磁共振成像（18F-FDG PET/MRI）在诊断胰腺癌术后复发中的价值[J]. 诊断学理论与实践, 2024 , 23(05) : 517 -523 . DOI: 10.16150/j.1671-2870.2024.05.008

Abstract

Objective To evaluate the value of 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) in the diagnosis of postoperative recurrence of pancreatic cancer. Methods The study included 86 consecutive patients after resection of pancreatic cancer from April 2018 to December 2023, who underwent 18F-FDG PET/MRI from August to September 2024. The efficacy of 118F-FDG PET/MRI in detecting postoperative recurrence of pancreatic cancer was retrospectively analyzed, and compared with that of serum carbohydrate antigen 19-9 (CA19-9) concentration in the diagnosis of recurrence. Results Follow-up confirmed that 67.4% (58/86) of patients experienced recurrence. The primary tumor diameter in the recurrence group (3.4±1.3cm) was larger than in the non-recurrence group (2.7±1.2cm). Among the patients with recurrence, 87.9% (51/58) had systemic recurrence, with the most common sites being liver metastasis and peritoneal metastasis. PET/MRI results changed the treatment plans for 30.2% (26/86) of patients. Among the 86 cases, 79 patients underwent both PET/MRI and serum CA19-9 tests. PET/MRI showed higher diagnostic efficacy for detecting postoperative recurrence of pancreatic cancer compared to serum CA19-9 (AUC: 0.847 vs. 0.719 ). PET/MRI detected 9/12 cases of pancreatic cancer recurrence with normal serum CA19-9 levels, and excluded 5/8 patients with elevated serum CA19-9 levels who did not experience recurrence. Conclusions PET/MRI has great clinical value in the diagnosis of postoperative recurrence of pancreatic cancer. It is particularly meaningful for patients with normal serum CA19-9 level. It can not only diagnose recurrence but also provide the specific site of tumor recurrence and comprehensive information for the formulation of the next treatment plan.

Key words： Pancreatic ductal adenocarcinoma; Recurrence; 18F-FDG PET/MRI

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